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Viewing report
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Decisions Decisions Decisions!. Edition No. 1
VDM Publishing House, Sep 2008, Pages: 280
Staff who work in front line, direct contact support
positions with community based clients with acquired
brain injuries (ABI) hold unique responsibilities,
and face unique challenges in their work due to the
combination of three key factors: autonomous work
environments, socially sanctioned power status over
clients, and the decision making deficits of clients
with ABI. These factors further contribute challenges
to staff in the presently complex and ambiguous
outreach context, where the embedded ideologies of
the medical model of treatment remain in tension with
the purported ideologies of the social model of
disability and client self determination that drive
outreach services. This work documents decision
making strategies used by interview participants,
examines the factors that influence their decision
space when in the field with clients, and explores
the role staff awareness of professional and personal
values plays in making decisions in the best of
interest of the client. Staff awareness is shown to
be a critical, yet oft neglected factor in
consideration of staff ethical decision making in ABI
outreach. Implications for best practices in the
field are discussed.
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